Jessica H. Bailey

The Pharmacist-Physician Relationship in the Detection of Ambulatory Medication Errors

Background:Expenditures on outpatient prescription drugs have increased enormously in the last decade. Despite this growth in expenditures, prescription medication safety in the ambulatory setting is lacking. Prior research in outpatient care has centered around the physician-patient encounter. What remains unexamined in the ambulatory care literature is the pharmacist’s role as interceptor, detector, and reporter of medication errors to the physician. Methods:Data about the role, responsibilities, and expectations to inform physicians about this subject were collected from pharmacist (N = 30) and patient (N = 31) focus groups conducted between July 2002 and July 2003. Pharmacists in outpatient practices and patients were randomly selected from the state licensure database and the Jackson Metropolitan phonebook, respectively. Analysis:Grounded theory provided the perspective on which data were interpreted. Data patterns were linked using key words and phrases for theme analysis. Arbitration between coders resulted in an inter-rater reliability of 0.85. Results:Three complementary patterns were identified from the data: 1) patients likely see multiple physicians and only one pharmacist; 2) patients are more likely to report medication errors to the pharmacist than to the physician; and 3) pharmacists are the final interceptors, detecting medication errors before they reach patients. Conclusions:Ambulatory pharmacists are in a privileged position to gather data regarding adverse responses to prescribed medication or incidents of medication mishaps. The failure of pharmacists to report information back to physicians is a missed opportunity to improve patient safety.

Providing healthcare to evacuees in the wake of a natural disaster: opportunities to improve disaster planning.

Background:The impending landfall of Hurricane Katrina on the Mississippi Gulf Coast resulted in large numbers of evacuees into the Jackson, Mississippi area. Many evacuees with chronic medical problems had been directed to the Mississippi Coliseum in the downtown area near the University of Mississippi Medical Center. As the storm passed through Jackson, serious damage occurred to the municipal infrastructure. In this article, we asked how that experience has affected health planning for the care of sheltered populations. Methods:We reviewed the information accumulated in the course of operating a large medical clinic for evacuees at the Mississippi Coliseum. We also contacted representatives of disaster planning agencies and of healthcare planning organizations to determine changes that have occurred in strategic plans subsequent to Katrina. Results:Using the resources of our academic health center, we were able to effectively deliver healthcare to sheltered evacuees. A model has been developed for future use from this experience. Much progress has been made toward preparation for care of the chronically-ill who may be displaced by future disasters. Conclusion:Hospitals and clinics on major evacuation routes for natural disasters can expect the sudden necessity to provide care to evacuees. Unless plans to care for chronically-ill individuals are incorporated into hospital disaster plans, local healthcare facilities may be unprepared to provide care. Many evacuees will have limited resources to pay for services. Academic medical centers have unique resources and capabilities to lead in the care plans for these populations.

Occupational Therapy Practitioners’ Perceptions of Important Competencies for Handwriting Evaluation and Intervention in School-Aged Children

ABSTRACT Objective. The primary purpose of this study was to identify the practitioner competencies that occupational therapists perceive as important for handwriting evaluation and intervention in school-aged children. A secondary purpose was to compare the practitioner perceptions of those in school-based practice with those from other primary practice settings. Method. A stratified random sample of 376 occupational therapists recruited from a national professional organization database participated by completing a survey instrument containing 80 competency items. Results. A majority of the 80 practitioner competency items were perceived to be of high importance to the respondent groups. A significance difference in perception when comparing the school-based practitioners to all other practitioners was revealed in only 3–12 competency summary categories. Conclusion. Practitioner competency survey items were perceived to be of high importance to the participants. School-based practitioner perceptions of competency were, for the most part, mainly similar to those in other primary practice settings.

The Educational Psychology of Clinical Training

ABSTRACT Clinical training is paramount to the educational experience of learners, and the purpose of this training can be categorized into the following 4 categories of learning taxonomies: socialization, clinical reasoning, medical management of patient care and attitudinal change. This article investigates the educational psychology that provides the foundation of the categories of learning that take place in the clinical environment. Understanding this is critically important to create an opportunity for learners to activate their knowledge repertoire at the precise time of appropriate application.

Occupational Therapists' Perceptions of Important Practitioner Competencies for Handwriting Evaluation and Intervention in School-age Children

The study purpose was to identify practitioner competencies occupational therapists perceive as important for handwriting evaluation and intervention in school-age children. Examination of the influence of practice setting and years of experience were also investigated. A national sample of 376 occupational therapists participated via survey. A total of 68 of 80 items were perceived to be of high importance. The top five identified items were eye-hand coordination, motor planning, review of work samples/direct observation, visual motor integration, and provision of education to teachers, parents and administrators. Analysis indicated minimal difference due to practice setting in the domains of handwriting and assessment of legibility. No significant differences based on practitioner experience were revealed. Eighty-five percent of the items were perceived as highly important. Practitioner perceptions of competency were mainly similar regardless of practice setting or experience.